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There Is More to Self-Pay Patients Than You Think

In today’s complex healthcare environment, many patients who are classified as self-pay may have insurance coverage that could be billed for services. The causes for this discrepancy range from registration process breakdowns to human data entry errors to incomplete or inaccurate data sent from third parties. Regardless of where in the process the error or omission was made, it impacts diagnostics providers’ ability to identify valid insurance coverage and other important demographic patient data.

As a result, the balance sheet of laboratories and other diagnostics providers are affected by uncollected cash and higher bad debt. The less obvious but more impactful effects of missing patient information are ever-increasing operating expenses. As your business grows, so do your collections expenses and the size of your billing teams. No matter how good your team is, the manual approach to resolving data issues results in delays in claim submissions and increased business risk related to “timely filing” requirements. Plus, those front-line billing team members may inadvertently negatively impact their relationship with your physician clients and/or patients when they reach out to them for missing information.

FrontRunnerHC estimates that nearly 40% of self-pay accessions actually have insurance coverage.

Identifying patient demographic and insurance information doesn’t have to be manual. Help your billing team deliver the best service by providing technology that automates this manual process. As a result, your billing team members can focus on higher-value activities like delighting your physician clients and delivering the best patient experience possible. No one wants to have to hound a client for missing or incorrect information – doing this day in and day out can burn your billing team out and cause low morale and engagement. In today’s competitive job market, you want to keep your best team members happy so that they keep your customers happy.

What if you could provide your billing team with technology that accesses a variety of databases to cross-reference patient identification records, and insurance information efficiently for self-pay patients?  

What if the newly found insurance coverage information could be automatically updated within a claim and submitted to the correct insurance company without human intervention?

This technology exists, and it is easy to implement. Even with minimal data, strong insurance discovery solutions can identify coverage, and the associated in or out of network benefits, regardless of the state where the patient resides. Insurance discovery reduces the need for human intervention and the associated workload on your staff. It also assists in maintaining compliance with your government and commercial payors’ rules and regulations.

FrontRunnerHC’s insurance discovery solution PatientRemedi has been shown to increase insurance discovery by 38%. Since integrating PatientRemedi with XIFIN RPM, more than $3.5 million in net new billable coverage has been identified, and XIFIN clients have averaged a 5.5% increase in revenue.

To learn more about FrontRunner and how its real-time, automated health insurance discovery is helping XIFIN RPM clients collect more revenue, click here.


Published by XIFIN
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